Nose surgery, or rhinoplasty, is an effective way to bring balance to the face. This procedure not only reshapes and resizes the nose for a more aesthetically pleasing look, but also can rejuvenate a patient’s confidence.

Why Nose Surgery

The nose is visually the most prominent feature of the face, and functionally, needs to allow the ability to breathe. Yet aesthetically, the nose should not distract from other desirable features of the face such as brilliant, youthful eyes. Many patients, therefore, seek a change to their nasal appearance.

Patients seek out our very own Dr. Daniel Butz and Dr. Andrew Campbell for cosmetic reasons such as decreasing or increasing the nose size, altering the tip or bridge, or changing the shape of the nostrils. Our expert surgeons provide functional rhinoplasty to correct structural defects in the nose that cause breathing problems, revise birth defects, and correct problems caused by injury.

The Rhinoplasty Nose Surgery Procedure

There is no age requirement for rhinoplasty since it can be performed for cosmetic or medical reasons. However, Dr. Campbell and Dr. Butz typically have younger patients wait until their nose has completely developed, around age 14 or 15 for girls and age 17 to 18 for boys, before performing the procedure.

Before rhinoplasty surgery, our doctors will discuss the patient’s nasal history and perform a thorough examination of the external and internal nasal anatomy. This allows him to create a plan for reshaping the problem areas of the nose. With digital imaging, Dr. Campbell and Dr. Butz can show the patient the possible postoperative outcome and address any concerns they may have. Our surgeons feel that it is imperative that patients go through computer imaging so they can get a feel for what their nose will look like after surgery.

The outpatient rhinoplasty procedure typically takes one to two hours and is performed at the surgical center. During surgery, your doctor will make incisions inside the nose or across the skin that separates the nostrils. This exposes the internal cartilage and bone. The doctor then removes, repositions, adds, and sculpts the cartilage and bone to create the look that is desired. Frequently, Dr. Campbell and Dr. Butz will remove a portion of bone and cartilage from the bridge to remove a nasal “hump,” and sutures are often used to create a thinner, more aesthetically pleasing nasal tip.

Rhinoplasty Recovery and Results

After nose surgery, the doctor places a thin plastic and metal splint over the bridge of the nose. Unlike other surgeons, Dr. Campbell and Dr. Butz leave no packing in the nose during recovery. This allows the patient to breathe through their nose and have a significantly more comfortable recovery period. Patients can go home the same day as surgery but need a responsible adult to drive them home. It is then important for the patient to keep their head elevated to minimize swelling and maintain nasal breathing. Some mild bleeding is common during the first 24 to 48 hours, and the patient may experience a dull headache, but pain is typically minimal.

Rhinoplasty patients at Quintessa are typically able to return to their normal routine about a week after surgery. At this point, the sutures that were placed on the outside of the nose and the splint can both be removed. A small amount of bruising may occur under the eyes, which almost always subsides within a week. The majority of swelling typically subsides within the first few weeks, but residual mild swelling in the nose may exist for several months, especially at the tip of the nose. For this reason, final results may not be visible for six months to a year. However, the majority of the improvement is noticeable as soon as the splint is removed. The results of a rhinoplasty are permanent and scarring is generally minimal.

Revision Rhinoplasty Surgery

Revision rhinoplasty is performed to correct a previous nose surgery which resulted in an undesired appearance or breathing difficulties. Dr. Campbell and Dr. Butz are both highly experienced in performing this procedure. In fact, many of our patients are referred by medical colleagues who are familiar with their skill and expertise.

Nasal surgery is complex and even the most gifted surgeons have patients that require revision rhinoplasty. Revision rhinoplasty is typically reserved for patients that are unhappy with the results. It’s important to allow the nose to have time to heal prior to considering undergoing a revision rhinoplasty. A minimum of 12 months should have elapsed to allow adequate healing and swelling reduction, but our doctors are happy evaluate a potential revision rhinoplasty candidate any time during their healing phase.

In some cases, swelling in the nose can persist for beyond a few months. Therefore, the final results may not be visible for up to a year. Once the swelling resolves, all abnormalities can be appreciated and a plan can then be made to resolve any concerns regarding the patient’s appearance or breathing.

Revision rhinoplasty can be challenging due to the scar tissue and reduced cartilage framework. Frequently, additional cartilage is required to help provide needed support and structure to the nose. Dr. Butz has experience utilizing advanced techniques, such as rib or ear cartilage grafting, to improve your nasal contour and your breathing.

Best candidates for Revision Rhinoplasty

Revision rhinoplasty patients may be seeking aesthetic and functional improvement. Ideal candidates are in good general health and have any of the follow issues:

  • A dorsal hump on the nasal bridge
  • Pollybeak deformity
  • Saddle nose deformity
  • Inverted V deformity
  • Retracted nasal ala
  • Collapsed nasal valves
  • Difficulty breathing through the nose

Revision Rhinoplasty Technique

Revision rhinoplasty is typically performed with an open approach unless it is a small bony deformity. Depending on how much septum you have remaining will determine if you need cartilage graft from your ear or your rib. This will be discussed with extensive preoperative care.

Postoperative Recovery

Nasal surgery is typically an outpatient procedure and performed in an accredited surgical facility with the assistance of an anesthesiologist. The procedure may take between 3-4 hours. Nasal packing is rarely used but thin nasal splints and a cast will be in place for 7 days. It typically is not that painful but you may have a dull aching sensation for the first few days. Head elevation and ice are helpful to reduce swelling and bruising.

The majority of the swelling will be resolved by 10-14 days but it may take 6-9 months for the final nasal contour to be appreciated as the healing process occurs.

If you would like to improve your confidence with rhinoplasty or are unhappy with a previous nasal surgery, please contact Quintessa for a complimentary consultation.

Realself Q&A

Dr. Andrew Campbell - RealSelf Q&A

Is It normal to have a permanent tingling at the bottom of the nostrils after having a rhinoplasty?

Rhinoplasty can leave patients with a variety of "side effects" such as swelling, tingling, stiffness, and discomfort. These can come and go or wax and wane over the first year of recovery. Fortunately, these symptoms almost always resolve over time. At the most, symptoms like this should resolve on their own within a year or two.

Can rhinoplasty and septoplasty be performed together?

For the vast majority of my cosmetic rhinoplasties I am performing a septoplasty at the same time, either for the harvesting of cartilage to use in the rhinoplasty or to straighten a crooked septum for breathing. In fact, for S-shaped septal deviations, it is easier to correct the deflection during a rhinoplasty than to just do the septoplasty alone. I would say most experienced rhinoplasty surgeons would perform a septoplasty at the same time as a rhinoplasty. I see no reason why anyone wouldn't.

Can the nose become crooked after rhinoplasty?

I understand your concerns. Visible deviations after a rhinoplasty and septoplasty are not expected, but are certainly not uncommon. I would recommend discussing your concerns with your surgeon. I typically have my patients massage the nose starting about 2-3 weeks after a rhinoplasty. If there is a visible deviation or crookedness, I have them massage the nose toward the direction we want it. That would be very difficult to do with the septum, so if there is continued mild deviation after surgery (which is quite uncommon), I will have them wear a nasal cone at night. A nasal cone is a soft silastic tube/basket that places a small amount of pressure on the septum, helping it maintain a midline position.

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Milwaukee & Madison Area Rhinoplasty Services

At Quintessa Aesthetic Center, we’re proud to serve Wisconsin’s greater Milwaukee and Madison areas.

We currently perform nose surgery (rhinoplasty) at the following locations:

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